破裂型腹主动脉瘤开放手术围手术期并发症防治要点

破裂型腹主动脉瘤（rAAA）起病急、病情重、病死率高，目前开放手术依然是处理rAAA的基本术式。笔者从诊断、术中注意事项和术后治疗3个方面论述rAAA开放手术围手术期并发症防治措施，指出：rAAA并发症需防治并重，“防”之重点在于提高诊断效率，减少失血量，术中缩短阻断时间并维持血流动力学稳定；“治”之要点在于早期发现，明确病因，对因治疗，避免诱因，改善症状。

Prevention and management of perioperative complications in open repair for ruptured abdominal aortic aneurysm

Ruptured abdominal aortic aneurysm (rAAA) is characterized by a rapid onset, severe progression and high mortality and so far, open repair is still the predominant procedure for rAAA. In this paper, the author discusses the prevention and management of perioperative complications in open repair for rAAA, from three aspects: diagnosis, intraoperative considerations and postoperative management. It is pointed out that equal attention must be paid to both prevention and treatment of the complications of rAAA. The emphasis of prevention is placed on improving diagnosis, reducing blood loss, decreasing the time to aortic occlusion and maintaining hemodynamic stability; the essential strategy for treatment is based on early detection, ascertaining the causes and eliminating predisposing factors, and relieving symptoms.